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Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study)

S Dahaghin¹, S M A Bierma-Zeinstra¹, A Z Ginai³, H A P Pols², J M W Hazes², B W Koes¹

¹ Department of General Practice, Erasmus Medical Centre, Rotterdam, Netherlands
² Department of Epidemiology and Biostatistics, Erasmus Medical Centre
³ Department of Radiology, Erasmus Medical Centre

Correspondence to:
Dr Saeede Dahaghin
Department of General Practice, Room Ff 325, Erasmus Medical Centre, PO Box 1738, 3000 DR Rotterdam, Netherlands; s_dahaghin{at}yahoo.com

Objective: To investigate the prevalence and pattern of radiographic osteoarthritis (ROA) of the hand joints and its association with self reported hand pain and disability.

Methods: Baseline data on a population based study (age 55 years) were used (n = 3906). Hand ROA was defined as the presence of Kellgren–Lawrence grade 2 radiological changes in two of three groups of hand joints in each hand. The presence of hand pain during the previous month was defined as hand pain. The health assessment questionnaire was used to measure hand disability.

Results: 67% of the women and 54.8% of the men had ROA in at least one hand joint. DIP joints were affected in 47.3% of participants, thumb base in 35.8%, PIP joints in 18.2%, and MCP joints in 8.2% (right or left hand). ROA of other joint groups (right hand) co-occurred in 56% of DIP involvement, 88% of PIP involvement, 86% of MCP involvement, and 65% of thumb base involvement. Hand pain showed an odds ratio of 1.9 (1.5 to 2.4) with the ROA of the hand (right). Hand disability showed an odds ratio of 1.5 (1.1 to 2.1) with ROA of the hand (right or left).

Conclusions: Hand ROA is common in the elderly, especially in women. Co-occurrence of ROA in different joint groups of the hand is more common than single joint disease. There is a modest to weak association between ROA of the hand and hand pain/disability, varying with the site of involvement.

Abbreviations: CMC1/TS, first carpometacarpal and trapezioscaphoid joint; DIP, distal interphalangeal joint; K-L, Kellgren–Lawrence radiological grade; MCP, metacarpophalangeal joint; PIP, proximal interphalangeal joint; ROA, radiographic osteoarthritis

Keywords: disability; osteoarthritis; hand

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